Cancer of the ovary is the leading cause of death from gynecologic malignancies and the fourth common cause of cancer-related death among women. This is in spite of the fact that the occurrence of ovarian cancer is relatively rare. Only 1.5% of women develop the disease, and it is only the seventh most common cause of cancer in women.
Ovarian cancer can be divided into three sub-types depending on the cell type involved, namely, epithelial, stromal and germ cell tumors.
At least 80% of malignant ovarian tumors arise form the coelomic epithelium. The most common type is serous crystadenocarcinoma, which accounts for 75% of cases of epithelial ovarian cancer.
Most women (75%) present with advanced-stage disease, and most have vague, nonspecific symptoms, such as dyspepsia, bloating, early-satiety anorexia, gas pains and backache. The most common early finding is an adnexal mass, which is often solid, irregular, and fixed. A patient may be asymptomatic until the disease is advanced. Occasionally, a patient presents with severe abdominal pain secondary to torsion of the ovarian mass. Late in the course, pelvic pain, anemia, cachexia, and abdominal swelling due to ovarian enlargement or accumulation of ascitic fluid usually occur. Nodular implants noted on the rectovaginal examination suggest extensive pelvic malignant disease.
Stromal tumors constitute only a tenth of ovarian malignancies but account for most of the hormone-secreting tumors.
Germ cell tumors comprise less than 5 percent of ovarian malignancies, occur in young women, and have a higher incidence in African-American women than Caucasian women. Functional effects of germ cell or stromal tumors include hyperthyroidism, feminization, and virilization.
After surgery to remove the tumor chemotherapy is usually provided. The initial chemotherapeutic regimen is three to six courses of chemotherapy. Paclitaxel is combined with cisplatin or carboplatin. Other chemotherapeutic drugs include topotecan, hexamethylmelamine, ifosfamide, doxorubicin, bleomycin and etoposide. In spite of the regimens, the five-year survival rate of patients with stage II disease is only fifty to seventy percent and thirty to forty percent for patients with stage III disease.
Thus, there is a need for new therapeutics that can be used to treat ovarian cancer.